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General practice after-hours incentive funding: a rationale for change
journal contribution
posted on 2023-05-18, 12:11 authored by Amanda NeilAmanda Neil, Mark NelsonMark Nelson, Richardson, T, Mann-Leonard, M, Andrew PalmerAndrew Palmer- After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP).
- In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance.
- In this article, we examine the drivers of the 1998–2013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania.
- The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice.
- Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas.
- The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives.
- A new after-hours incentive funding mechanism embodying pre-specified objectives — such as support for (unavoidable) burden and/or provision of care to residential aged care facilities — is required. Claimed provision is considered an inappropriate funding determinant.
History
Publication title
Medical Journal of AustraliaVolume
203Pagination
82-85ISSN
0025-729XDepartment/School
Menzies Institute for Medical ResearchPublisher
Australasian Medical Publishing Company Pty. Ltd.Place of publication
AustraliaRights statement
Copyright 2015 MJARepository Status
- Restricted
